There are two main histologic variants of gastric adenocarcinoma. The most frequent is the "intestinal type," so called because of its morphologic similarity to adenocarcinomas arising in the intestinal tract. The less common diffuse type gastric cancers are characterized by a lack of intercellular adhesions, which leaves them unable to form glandular structures. In patients with inherited form of diffuse type gastric cancer, the absence of intercellular adhesions is caused by a germline mutation in the cell adhesion protein E-cadherin (CDH1). (See 'Hereditary diffuse gastric cancer' below.)

One model for the "intestinal type" of gastric cancer describes a progression from chronic gastritis to chronic atrophic gastritis, to intestinal metaplasia, dysplasia, and eventually to adenocarcinoma [1,2].

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World Cancer Research Fund/American Institute for Cancer Research (2007). Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. World Cancer Research Fund/American Institute for Cancer Research: Washington DC.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, Schistosomes, Liver Flukes and Helicobacter pylori. Vol 61 of IARC monographs on the evaluation of carcinogenic risks to humans. International Agency for Research on Cancer, Lyon, 1994.